摘要
目的 探讨异基因造血干细胞移植(Allo-HSCT)后应用TKI药物维持治疗的疗效.方法 回顾性分析70例成人Ph+ALL的临床资料,通过比较移植后TKI(+)组及TKI(-)组的OS、DFS、复发率、白细胞植入时间、血小板植入时间、Ⅱ-ⅣaGVHD及cGVHD等指标,评估移植后TKI维持治疗Ph+ALL的疗效.结果 70例成人Ph+ALL患者中男性41例,女性29例,年龄15~58岁,中位年龄35岁.移植后TKI(+)组的平均OS、DFS分别为59.609个月、59.640个月,均高于TKI(-)组(39.678个月、37.154个月)(P<0.05).而TKI(+)组的复发率(11.63%)低于TKI(-)组(29.63%),但差异无统计学意义(P=0.059).标准剂量组和低于标准剂量组、一代TKI组和二/三代TKI组等亚组的OS和DFS差异均无统计学意义(P>0.05).结论 Allo-HSCT后给予TKI药物维持治疗可改善Ph+ALL患者OS、DFS,同时降低移植后NRM率及复发率,是减少移植后复发、改善长期生存的安全有效治疗手段.
Objective To investigate the effect of TKI maintenance treatment after allogenic hematopoietic stem cell transplantation(Allo-HSCT).Methods The clinical data of 70 cases of adult patients with Ph+ALL admitted were retrospectively analyzed.The indexes of OS,DFS,recurrence rate,leukocyte implantation time,platelet implantation time,Ⅱ-ⅣaGVHD and cGVHD were compared between the TKI(+)group and the TKI(-)group after transplantation.Results A total of 70 patients with Ph+ALL were enrolled,including 41 males and 29 females,with a median age of 35 years(aged 15-55 years).The mean OS and DFS of TKI(+)group were 59.609 months and 59.640 months respectively,which were higher than those in TKI(-)group(39.678 months,37.154 months)(P<0.05).The recurrence rate(11.63%)in TKI(+)group was lower than that in TKI(-)group(29.63%),but the difference was not statistically significant(P=0.059).Moreover,there was no significant difference in OS and DFS between the standard dose group and the low standard dose group,the generation TKI group and the second/third generation TKI group(P>0.05).Conclusion Post-transplant maintenance therapy with TKI is safe and effective treatment to reduce the recurrence after transplantation and improve long-term survival,because it may improve Ph+ALL patients'OS and DFS,at the same time reduces the NRM rate and relapse rate after transplantation.
作者
陈明
马骁
姚建新
杨学东
刘强
CHEN Ming;MA Xiao;YAO Jian-xin;YANG Xue-dong;LIU Qiang(Department of Hematology,Changshu Second People's Hospital,Changshu,Jiangsu,215500,China;Department of Hematology,First Affiliated Hospital of Soochow University,Jiangsu Institute of Hematology,Suzhou,Jiangsu,215006,China)
出处
《中国血液流变学杂志》
CAS
2020年第3期298-303,共6页
Chinese Journal of Hemorheology
关键词
白血病
PH染色体
酪氨酸激酶抑制剂
异基因造血干细胞移植
leukemia
Ph chromosome
Tyrosine kinase inhibitor
allogeneic hematopoietic stem cell transplantation
作者简介
陈明(1988-),男,江苏常熟人,硕士,主治医师,研究方向:血液系统各类疾病的诊治;通讯作者:马骁,E-mail:pony73sz@hotmail.com
